Although the survival time of patients with vertebral metastases from lc has increased over the last 10 years, the overall outcome is still poor. For the prediction of an individual prognosis in the group of lc patients the score of Tokuhashi seems to be a suboptimal tool. We conclude that therapeutic decisions for such patients should be made based on interdisciplinary platforms, especially in the light of improved systemic treatment options.

Patients with neurologic deficit because of spinal bone metastases benefit from early operative intervention. Urgent surgery is indicated in patients with less than 3 days of neurologic deficit.